Description

How it works

• Suboxone combines buprenorphine (a unique drug that has some effects on opioid receptors but less than those seen with full opioid agonists such as oxycodone and morphine) with naloxone (a drug that blocks the effects of opioids).
• Suboxone helps to reduce withdrawal symptoms and curb cravings for opioids by tricking the brain into thinking that a full agonist like oxycodone or heroin has been taken.
• Suboxone is used in the treatment of opioid (narcotic) addiction.

Upsides

• May be used for the treatment of opioid addiction.
• Has advantages over other medication-assisted treatments (such as methadone and naltrexone) in that it suppresses withdrawal symptoms and cravings for opioids, which does not cause euphoria (the feeling or state of intense excitement and happiness) and also blocks the effects of other opioids for at least 24 hours.
• It helps people to change their thinking, behavior, and environment. Complements education, counseling,, and other support measures that focus on the behavioral aspects of opioid addiction.
• Success rates of 40-60% have been reported; far higher than the under 25% success rate achieved by going cold turkey.
• Long-acting, only needs to be taken once a day.
• If full opioids are taken within 24 hours of a Suboxone dose, they will not work, allowing the patient time to reconsider the wisdom of relapsing.
• Suboxone is available as a generic under the name buprenorphine hydrochloride/naloxone hydrochloride sublingual tablets.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• A headache, chills, drowsiness, constipation, rhinitis, nausea, pain, insomnia, sweating, a lack of energy or a drop in blood pressure when going from a standing to a sitting position.
• Allergic reactions (including breathing difficulties, rash, and anaphylactic shock) and liver damage have been reported.
• It can only be prescribed by physicians who meet certain qualifying requirements, and who have been assigned a unique identification number that must be included on every prescription.
• Abuse potential exists, although it is substantially lower than methadone. Take steps to store your medicines safely to minimize the risk of theft and misuse. Treatment is also regulated, but not as highly regulated as methadone treatment.
• Buprenorphine has been associated with breathing difficulties and death, most often the IV form and when used at the same time as benzodiazepines, alcohol or other CNS depressant drugs. Avoid self-administration of other medications while taking Suboxone except on a doctor’s advice.
• May not be suitable for people with head injuries, acute abdominal conditions, or preexisting respiratory disease (such as COPD, asthma).
• Can also cause dependence and a withdrawal syndrome on abrupt discontinuation although this is typically milder than that seen with full agonists.
• May cause drowsiness and affect a person’s ability to drive or operate machinery.
• May interact with some medications including some antifungals and HIV antiretrovirals.

Tips

• Suboxone should always be used as part of a complete treatment plan that includes counseling and psycho-social support. Subutex (buprenorphine) tablets are usually used initially for induction before Suboxone is prescribed.
• Suboxone sublingual tablets should be placed under the tongue and allowed to dissolve. Swallowing the tablets reduces their effectiveness.
• Continued treatment with Suboxone usually depends on compliance with all elements of the treatment plan and abstinence from illicit drug use.
• Take exactly as directed; do not misuse.
• Seek immediate medical help if you develop blurred vision, are excessively sleepy or uncoordinated, have slurred speech, have slowed reflexes or breathing, or have significant problems thinking.

 Response and Effectiveness

• Quickly absorbed via the sublingual route. Maximum concentrations reached within two hours.
• There may be a difference in effectiveness between Suboxone sublingual tablets and Suboxone sublingual film. Those switching may need to be monitored for over or under-medication.

This medicine may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away Suboxone is against the law.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Use dry hands when handling Suboxone. Place the sublingual tablet or film under your tongue. Allow the medicine to dissolve slowly. Do not chew or swallow it whole.

If you switch between medicines containing buprenorphine, you may not use the same dose for each one. Follow all directions carefully.

Do not stop using Suboxone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

You will need frequent blood tests to check your liver function.

How should I take Suboxone?

All your medical care providers should know that you are being treated for opioid addiction, and that you take Suboxone. Make sure your family members know how to provide this information in case they need to speak for you during an emergency.

Never crush or break a Suboxone sublingual tablet to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death.

Store this medicine in the foil pouch at room temperature, away from moisture and heat. Discard an empty pouch in a place children and pets cannot get to.

Keep track of your medicine. Suboxone is a drug of abuse and you should be aware if anyone is using it improperly.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, remove any unused films from the foil pack and flush the films down the toilet. Throw the empty foil pack into the trash.